Firm Name Reservation Request Form
Please send completed form by mail, fax or
email to: FINRA
Regulatory Review and Disclosure Department
9509 Key West Avenue
Rockville, MD 20850
Fax: 301-216-3710
Email: DisclosureReviewOrga@finra.org
For questions, please contact the Gateway Call Center at 301-590-6500.
Note: Before submitting this Form, FINRA strongly encourages you to read and follow its
Firm Name Guidelines. Doing so will help ensure that the name you request complies with federal
law/regulations (including Regulation BI) and FINRA’s By-Laws, and that it is otherwise consistent
with the guidelines for proposed names described therein. If you are requesting a broker-dealer
name that, although similar to the name of a current member firm, you believe is unlikely to confuse
retail investors based on the limited scope of the firm’s business, please provide the necessary
information referenced in the guidelines.
Date:
Requestor’s Name and Title:
Company:
Address:
City:
State:
Zip Code:
Phone:
Fax:
Email:
Request Type: Broker Dealer Funding Portal
If this request is being made for a current FINRA member firm, please provide the firm’s name and CRD
Number:
Please list the name(s) you wish to reserve below. You may provide up to three names in order of
preference. FINRA will reserve the highest-ranked name that is acceptable.
Name(s) Requested:
1.
2.
3.
If the requesting firm has any affiliates that are registered with FINRA, please list the affiliate(s) below:
1. 2.
3. 4.
5. 6.